If you want to predict what you should be worrying about tomorrow, find out what insiders are worried about today. For example, it’s ever-so-enlightening to eavesdrop on the internal reports that Big Pharma stakeholders are reading, where the lowly, uninformed patient can find intriguing musings from pundits, those who are paid to stay one step ahead of the prescription pad.

At the Pharma Chem Outsourcing conference this month in New Jersey, speaker Stefan Loren of the investment firm Westwicke Partners revealed a sobering view of Big Pharma in his talk, “The Pharma Titanic: It’s Time To Root For the Iceberg”.

Mr. Loren opened his presentation with an overview of the U.S. national health care debate. He said that mandatory health insurance will be good for Big Pharma. But he also believes that there will be strong pressure for mandatory comparative effectiveness testing between drugs – not good for Big Pharma.

He sees global pharmaceutical sales declining, except for future growth coming in Asia and Latin America. He also sees evidence of “health care avoidance” – practices like unfilled prescriptions, unfinished courses of prescriptions, and people just not visiting medical and dental practitioners, also not a good trend for Big Pharma.

“The coming wave of patent expirations of the top 10 drugs will hit Big Pharma hard. Generics will grow: in 5-10 years, 80% of all prescriptions will be generic.  That means trouble ahead. For investors, the return on investment for Big Pharma is largely negative. It’s a “death spiral.” Continue reading →